(Test Bank) Basic Geriatric Nursing

Williams, 7

Nursing

Test Bank

7th Edition

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Test Bank for Basic Geriatric Nursing, The downloadable file consists of 330 pages, and the total size of the file is 5.5 MB. Purchase now only for highly discounted price.

Author(s): Williams

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Study Note Preview

BASIC GERIATRIC NURSING 7th EDITION BY WILLIAMS Description Prepare for a successful career in caring for geriatric populations! Williams’ Basic Geriatric Nursing, 7th edition is an easy -to-read text which presents the theories and concepts of aging along with appropriate nursing interventions. This comprehensive book helps you understand the unique physiologic and psychosocial changes that affect the elderly adult. Threaded throughout this new edition are practical QSEN boxes and Nurse Alert features, which highlight safety, cultural considerations, health promotion, coordinated care, and home care specific to elderly patients. In addition, an online Study Guide, NC LEX® -PN review questions, and real -world clinical situation boxes help you to study for exams and apply concepts to practice. Key Features  Coordinated Care boxes address such topics as restraints, elder abuse, and end -of-life care as related to responsibil ities of nursing assistants and other health care workers who are supervised by LPN/LVNs.  Clinical Situation boxes present patient scenarios with lessons for appropriate nursing care and patient sensitivity.  UNIQUE! A FREE Study Guide, presented in a compr ehensive PDF format on Evolve, reinforces your understanding.  10th grade reading level makes learning easier for you.  Nursing Care Plans include Critical Thinking boxes to help you to assimilate and synthesize information.  Nursing Process sections provide a framework for the discussion of the nursing care of the elderly patient as related to specific disorders.  Cultural Considerations throughout text cover biocultural variations as well as health promotion for specific ethnic groups so you can provide cultu rally competent care.  Health Promotion and Patient Teaching boxes highlight health promotion, disease prevention, and age -specific interventions.  Home Health Considerations boxes provide information on home health care for the older adult. Table of Content s Unit One: Overview of Aging 1.Trends and Issues 2.Theories of Aging 3.Physiologic Changes Unit Two: Basic Skills for Gerontologic Nursing 4.Health Promotion, Health Maintenance, and Home Health Considerations 5.Communicating with Older Adults 6.Maintaini ng Fluid Balance and Meeting Nutrition Needs 7.Medications and Older Adults 8.Health Assessment for Older Adults 9.Meeting Safety Needs of Older Adults Unit Three: Psychosocial Care of the Elderly 10.Cognition and Perception 11.Self -Perception and Self -Concept 12.Roles and Relationships 13.Coping and Stress 14.Values and Beliefs 15.End -of-Life Care 16.Sexuality and Aging Unit Four: Physical Care of the Elderly 17.Care of Aging Skin and Mucous Membranes 18.Elimination 19.Activity and Exercise 20.Sleep and Re st Chapter 1: Trends and Issues Multiple Choice 1. Since 1995 there has been a significant decrease in the rate of infant death related to which of the following: a. Disorders associated with short gestation and low birth weight b. Accidents c. Sudden infant death d. Newborns affected by complications of placenta, cord, and membranes ANS: c Feedback a. The rates of prematurity and low birth weight are increasing. b. The rates of accidents have increased. c. Correct. The rate of infant death related to SIDS has decreased from 87.1 to 47.2. The decrease in rate is partially attributed to placing infants on their backs when sleeping. d. The rates of newborns affected by complications of placenta, cord, and membranes have increased. 2. Tobacco use during pregnancy is associated with ad verse effects on the unborn infant such as intrauterine growth restriction, preterm births, and respiratory problems. By race, which has the highest percentages of smokers? a. American Indian and Alaskan Natives b. Asian or Pacific Islanders c. Non-Hispanic blacks d. Non-Hispanic whites ANS: a Feedback a. 36% of American Indian and Native American women are cigarette smokers. b. 4.3% of Asian or Pacific Islander women are cigarette smokers. c. 17.1% of non-Hispanic black women are cigarette smokers. d. 19.6% of non-Hispanic white women are cigarette smokers. KEY: Integrated Process: Clinical Problem Solving | Cognitive Level: Knowledge | Content Area: Maternity | Client Need: Safe and Effective Care Environment | Difficulty Level: Easy 3. Which of the following women is at the highest risk for health disparity? a. A white, middle -class, 16 -year-old woman b. An African American, middle -class, 25-year-old woman c. An African American, upper -middle -class, 19-year-old woman d. An Asian, low-income, 30-year-old woman ANS: d Feedback a. Although age is a risk factor, income contributes to disparity. b. Although African American women are at increased risk, income accounts for the largest disparity. c. Although age and race contribute to increased risk, income accounts for the largest disparity. d. Although age and race contribute to increased risk, income accounts for the largest disparity. 4. A neonate born at 36 weeks gestation is classified as which of the following? a. Very premature b. Moderately premature c. Late premature d. Term ANS: c Feedback a. Very premature is less than 32 weeks’ gestation. b. Moderately premature is 32 to 33 completed weeks’ gestation. c. Correct. Late premature is 34 to 36 completed weeks’ gestation. d. Term is 37 to 42 weeks’ gestation. 5. The perinatal nurse explains to the student nurse that a goal of the Healthy People 2020 report is to: a. Increase proportion of infants who are breastfed to 93.1%. b. Increase proportion of infants who are breastfed to 90.7%. c. Increase proportion of infants who are breastfed to 85.6%. d. Increase proportion of infants who are breastfed to 83.9%. ANS: d A goal of Healthy People 2020 is to increase the proportion of infants who are breastfed from 74% to 81.9%. 6. The perinatal nurse explains to the student nurse that is the leading cause of infant death in the United States. a. Sudden Infant Death Syndrome b. Respiratory distress of newborns c. Disorders related to short gestation and low birth weight d. Congenital malformations and chromosomal abnormalities ANS: d 7. Which of the following statements are true related to teen pregnancies? (Select all that apply.) a. Teen mothers are at higher risk for HIV. b. Teen mothers are at higher risk for hypertensive problems. c. The birth rate for teenaged women has increased in the past 15 years. d. Infants born to teen mothers are at higher risk for health problems. ANS: a, b, d Health statistics report higher risk for HIV, for hypertensive problems, and for health problems to infants born to teen mothers. Birth rates for teen mothers in all age categories have decreased since 1991. Chapter 2- Theories of Aging 1. Which of the following statements most accurately conveys an aspect of the error theory of aging? A) Perpetuation of DNA mutations results in organ and system malfunction. B) Age-related dysfunction of organs, tissues, and body systems results in mutation of body DNA. C) The number of cell divisions is genetically predetermined. D) Errors in the function of various organs contribute to changes in the genetic code of various body cells. Ans: A Feedback: The error theory of aging proposes that genetic mutations are perpetuated through the aging process, resulting in organ malfunction and eventual decline in body function. Organ malfunction results from, but does not cause, the genetic mutations in question. A genetic predetermination of the number of cell divisions is associated with the programmed theory of aging. Origin: Chapter 2- Theories of Aging, 2 Chapter: 2 Client Needs: D4 Cognitive Level: Comprehension Difficulty: Moderate Integrated Process: Nursing process Objective: 2 Page and Header: 15, Genetic Theories 1. The error theory of aging proposes a cause -and-effect relationship between the genetic activity of body cells and the effects of aging. Place the following steps in the error theory of aging in the correct chronological order. Use all the options. A) Organ, tissue, and system malfunction B) Perpetuation of mutation during cell divisions C) DNA mutation D) Overall decline in body functions E) Decline in body functions Ans: C, B, E, A, D Feedback: The error theory of aging proposes that DNA mutations occur on a single -cell level and are perpetuated in subsequent cell divisions. The overall number of mutant cells in the body increases and causes deleterious effects on tissues and systems and eventual decline in body function. Origin: Chapter 2- Theories of Aging, 3 Chapter: 2 Client Needs: D4 Cognitive Level: Comprehension Difficulty: Difficult Integrated Process: Teaching/learning Objective: 2 Page and Header: 14, Evolutionary Theories 2. A nurse is explaining to an older adult client that many of the changes in his body that are currently causing him frustration may have their origins in genetic changes that may have in fact benefited him during his younger years. Which of the following theories of aging underlies the nurse's explanation? A) Disposable soma theory B) Free radical th eory C) Mutation accumulation theory D) Antagonistic pleiotropy theory Ans: D Feedback: Antagonistic pleiotropy theory proposes that genetic mutations that are problematic in later life may be rooted in mutation that played a beneficial role earlier in life. This perspective is not a component of the disposable soma theory, free radical theory, or mutation accumulation theory. Origin: Chapter 2- Theories of Aging, 4 Chapter: 2 Client Needs: D4 Cognitive Level: Comprehension Difficulty: Moderate Integrated Process: Nursing process Objective: 2 Page and Header: 14, Free Radicals and Lipofuscin Theories 3. An 80-year-old female who enjoys good health explains to her primary care provider that she attributes her health status to her regular intake of berries, fruit juices, and green tea, which she states “help cleanse the damaging molecules out of my body.” Which of the following theories of aging underlies the client's health beha viors? A) Free radical theory B) Biogerontology C) Disposable soma theory D) Cross -linking theory Ans: A Feedback: The free radical theory of aging attributes damage to the accumulation of free radicals that may be countered by the intake of antioxidants. This is not an explicit component of the disposable soma or cross -linking theory of aging. Biogerontology is the study of the relationship between aging and disease. Origin: Chapter 2- Theories of Aging, 5 Chapter: 2 Client Needs: D4 Cognitive Level: Application Difficulty: Moderate Integrated Process: Teaching/learning Objective: 2 Page and Header: 15, Autoimmune Reactions 5.A nurse is discussing an older adult client's apparent increased susceptibility to infection with his family. Which of the following statements by the nurse would be most congruent with current thought around the autoimmune role in the aging process? A) “Changes that we call 'mutations' in your father's cells make his organs more vulnerable to chroni c illness and germs.” B) “Older adults often have more difficulty fighting off infections because of their weaker immune systems, and their bodies can even attack themselves.” C) “Diseases such as arthritis, which we term 'autoimmune,' make older people more likely to catch viruses and other bugs.” D) “Our bodies seem to have an 'expiry date,' after which we are far more likely to get infections and develop chronic illness.” Ans: B Feedback: Decreased immune response coupled with increased autoimmune activity is implicated in many of the effects of the aging process. The salience of mutations is associated with genetic theories of aging and autoimmune activity is not considered the direct cause of the decline in thymus and bone marrow activity. A predetermined cell life span is associated with the programmed theory of aging. Origin: Chapter 2- Theories of Aging, 6 Chapter: 2 Client Needs: C Cognitive Level: Application Difficulty: Moderate Integrated Process: Teaching/ learning Objective: 3 Page and Header: 16, Disengagement Theory 6.A hospital clinical educator is espousing the disengagement theory of aging when teaching staff how best to meet the needs of older clients. Which of the nurse's teaching points best captures the disengagement theory of aging? A) “Older adults often benefit from a gradual and controlled withdrawal of their own interests from society's interests.” B) “The disengagement between an older adult's abilities and desires can lead to frustration and, ultimately, to illness.” C) “The lack of synchronicity between older adults' immune systems and their environments can be the root of many problems.” D) “It is imperative that we ensure older adults remain engaged with interests and events beyond themselves.” Ans: A Feedback: Disengagement theory postulates that disengagement between the individual and society is beneficial to both parties. It does not propose that this process of withdrawal be prevented nor that it necessarily leads to frustration or illness. The immune system is not a central component of the theory. Origin: Chapter 2- Theories of Aging, 7 Chapter: 2 Client Needs: C Cognitive Level: Application Difficulty: Moderate Integrated Process: Teaching/learning Objective: 3 Page and Header: 17, Activity Theory 7. Which of the following directives by the head nurse at a long-term care facility is most reflective of the activity theory of aging? A) “We need to facilitate older adults' desire to step back from the responsibilities and roles they had in earlier years.” B) “It's hard to overestimate the importance of regular, physical exercise in maintaining health and healthy aging.” C) “We need to remember that the psychological roles and characters of our residents change profoundly in later years of life.” D) “We have to treat our residents like younger people and keep them engaged in meaningful acts.” Ans: D Feedback: The activity theory asserts that an older person should continue a middle -aged lifestyle, denying the existence of old age as l ong as possible, and that society should apply the same norms to old age as it does to middle age and not advocate diminishing activity, interest, and involvement as its members grow old. Stepping back from roles is associated with disengagement theory, an d psychological roles and character are not thought to change radically in later life. Physical exercise is not a central component of activity theory. Origin: Chapter 2- Theories of Aging, 8 Chapter: 2 Client Needs: C Cognitive Level: Analysis Difficulty: Difficult Integrated Process: Nursing process Objective: 3 Page and Header: 18, Developmental Tasks 8. Which of the following tasks are components of Erikson's description of the old age tasks of reconciling ego integrity with despair? Select all that apply. A) An 80-year-old man is struggling to determine his identity apart from his lifelong career as a business leader. B) A 79 -year-old woman has established habits that promote her financial independence in spite of a lack of savings. C) An 80-year-old man revels in his large, happy family rather than focusing on his mobility limitations resulting from Parkinson disease. D) A 77-year-old man is trying to determine whether his life has had deep significance and meaning. Ans: A, C, D Feedback: Deriving satisfaction from oneself rather than occupational roles, finding pleasure in spite of physical limitations, and determining meaning in the life one has lived are all aspects of Erikson's outcome of ego integrity or despair. Financial independence is not a central component of this outcome. Origin: Chapter 2- Theories of Aging, 9 Chapter: 2 Client Needs: C Cognitive Level: Application Difficulty: Easy Integrated Process: Nursing process Objective: 4 Page and Header: 20, Box 2-2 9. Which of the following actions by a nurse who works with older adult clients in an assisted living facility is most likely to inhibit healthy aging? A) Discussing current events with clients who read and watch television. B) Placing a bib on each client during meal times to ensure clients maintain a clean appearance. C) Challenging clients to learn new skills and develop preexisting talents. D) Facilitating introductions between new and existing clients. Ans: B Feedback: While the nurse' s action may have a laudable rationale, using a bib and feeding clients who may not require either action is incongruent with promoting function and preventing helplessness. Discussing current events and facilitating new skills and relationships promote we ll-being. Origin: Chapter 2- Theories of Aging, 10 Chapter: 2 Client Needs: C Cognitive Level: Application Difficulty: Moderate Integrated Process: Nursing process Objective: 3 Page and Header: 18, Developmental Tasks 10.A nurse notes that a 90 -year-old male client on a geriatric medical unit of the hospital has been talking about death frequently. Given that the nurse has good rapport with client, what is the nurse's most appropriate response? A) “Try to focus more on the positive benefits of healing rather than what might happen.” B) “Remember that in this day and age many people can live far beyond 90 years of age.” C) “I've noticed you've brought up the issue of dying a lot. How do you feel about that?” D) “You'll find that aiming for health rather than thinking about death will have positive results.” Ans: C Feedback: Preparing for death has been identified as a developmental task for later life and would be an appropriate topic for discussion given the partnership that exists between the nurse and the client and the client's desire to broach the subject. Origin: Chapter 2- Theories of Aging, 11 Chapter: 2 Client Needs: B Cognitive Level: Analysis Difficulty: Difficult Integrated Process: Nursing process Objective: 1 Page and Header: 19, Applying Theories of Aging to Nursing Practice 11.Nurses need to understand the aging process in order to help their patients: A) Live longer with their long-term disabilities B) Maintain youth and delay the onset of old age C) Accept the limitations imposed by genetic tendencies toward cellular degeneration D) Postpone the negative consequences of the aging process Ans: D Feedback: The promotion of positive health practices increases the chances that an individual can delay or deter the impairments and declines that frequently accompany the aging process. Living long in a disabled state is not the most desirable objective. Maintainin g youth is not an achievable goal. Accepting limitations is not necessary for many seniors and not life enhancing for many others. Origin: Chapter 2- Theories of Aging, 12 Chapter: 2 Client Needs: B Cognitive Level: Analysis Difficulty: Moderate Integrated Process: Nursing process Objective: 2 Page and Header: 13, Biological Theories of Aging 12. Mrs. H and Mrs. J are the same age. While in the doctor's waiting room, they discuss their ailments and their beliefs about aging. Mrs. H argues that Mrs. J must be older because she has more ailments. The nurse settles the argument by stating a cornerstone of all biological theories of aging. Which of the following statements did the nurse most likely make? A) Aging is a predictable cellular process. B) Cells undergo a finite number of divisions. C) No two individuals age identically. D) Body systems decline at the same rate. Ans: C Feedback: Individual variability is fundamental to all biological theories. Aging is not totally predictable, nor is it necessarily cellular in some biological theories. Body systems are often seen to decline at different rates. Origin: Chapter 2- Theories of Aging, 13 Chapter: 2 Client Needs: D4 Cognitive Level: Comprehension Difficulty: Moderate Integrated Process: Nursing Process Objective: 3 Page and Header: 15, Genetic Theories 13. Which of the following statements is evidence that supports the programmed theory of aging? A) The life spans attained by parents and their offspring are negatively correlated. B) Mutations perpetuate themselves through each cycle of cell division. C) In cultures, cells go through a finite number of cell divisions before dying. D) In cultures, cells from older donors divide faster than those from younger donors. Ans: C Feedback: Studies of in vitro cell proliferation have demonstrated that various species have a finite number of cell divisions. Life spans of parents and offspring ar e positively correlated. Mutation perpetration is a tenet of the error theory, not the programmed theory, of aging. Although longer life spans correlate positively with numbers of cell divisions in vitro, the rate of cell division is not affected. Origin: Chapter 2- Theories of Aging, 14 Chapter: 2 Client Needs: D4 Cognitive Level: Analysis Difficulty: Difficult Integrated Process: Nursing process Objective: 2 Page and Header: 14, Cross -Linking Theory 14. Which of the following statements form components of both the error theory of aging and the cross -linking theory of aging? A) Free radicals cause mutations in cells. B) Senescence is environmentally controlled at the cellular level. C) Changes in DNA lead to organ malfunctions. D) Genetic programming determines life expectancy. Ans: C Feedback: Both the error theory and the cross -linking theory assert some change in DNA that interferes with normal cell functioning. Such changes may be caused by free radicals or any of many other mutagens. Although the aging of cells may be environmentally influenced, it is not thought to be externally controlled. That genetic programming determines life expectancy is a basic tenet of the programmed theory of aging. Origin: Chapter 2- Theories of Aging, 15 Chapter: 2 Client Needs: D4 Cognitive Level: Comprehension Difficulty: Moderate Integrated Process: Nursing process Objective: 2 Page and Header: 14, Free Radicals and Lipofuscin Theory 15. Which of the following statements underlie both the error theory of aging and the free radical theory of aging? A) Biochemical damage accumulates over time, leading to cell death. B) The rate of cellular death is genetically programmed. C) The aging body produces fewer growth and repair hormones. D) Environmental agents such as radiation and heavy metals damage DNA. Ans: A Feedback: That the rate of cell death is genetically programmed is a basic tenet of the programmed theory of aging. That the aging body produces fewer growth and repair hormones is a neuroendocrine theory. Although radiation and heavy metals may damage DNA, they are not free radicals, and they need not be the cause of the mutations assumed by the error theory. Origin: Chapter 2- Theories of Aging, 16 Chapter: 2 Client Needs: D4 Cognitive Level: Application Difficulty: Moderate Integrated Process: Nursing process Objective: 2 Page and Header: 15, Autoimmune Reactions 16. The nursing staff at a nursing home works closely with the staff in the Endocrinology Department at a local hospital. This relationship is maintained for the welfare of the nursing home residents, because a failing immune system in the elderly might account for: A) A decline in the rate of growth hormone production B) The increased incidence of cancer among the aged C) The oxidative activity of free radicals D) Changes in brain activity and nervous system function Ans: B Feedback: Compromises in the immune systems of the elderly may lead to a failure to recognize and destroy cancerous cells. The immune system is not involved in the production of growth hormones. The immune system does not determine the action of free radicals, although it may be involved in seeking out and destroying cells damaged by free radical activity. There is no known association between diminished immune activity and changes in the brain or nervous system action. Origin: Chapter 2- Theories of Aging, 17 Chapter: 2 Client Needs: D4 Cognitive Level: Knowledge Difficulty: Easy Integrated Process: Nursing process Objective: 2 Page and Header: 15, Autoimmune Reactions 17. Although the immune system is affected by the aging process, the elderly are not the only individuals who have autoimmune disorders. These occur in populations of all ages because autoimmune disorders involve: A) An attack of antibodies on body cells B) An overproduction of T cells in bone marrow C) A decrease in the weight of the thymus gland D) An increase in the amount of lipofuscin in the blood Ans: A